Healthcare Staff's Racialised talk : Examining Accounts of Racialisation in Healthcare

This thesis contributes to the literature on racism in healthcare and the scholarship on racism and racialisation by moving the current focus of healthcare literature from demonstrating the existence of racism to examining accounts of racialisation through analysing healthcare staff’s racialised talk. Drawing from critical ‘race’ and postcolonial theories, the thesis departs from the premise that racism is a structural phenomenon embedded in nation states and institutions, including healthcare across the globe. Through a scoping review ofstudies on racism in healthcare, this thesis maintains that the current literature does not conceptualise racism as structural, and does not attempt to uncover accounts of racialisation. The review argues that the trends uncovered are part of why racism continues to reproduce itself in healthcare, despite equality regulations and policy makers’ efforts to eradicate racism. The thesis posits racialisationas a process situated within the sociohistorical playing out of colonial domination, where in groups of people are stratified somatically and culturally within groups of subordination and supraordination. Societies, institutions, and interactions are viewed as racialised such that an analysis ofracialised talk captures the seemingly subtle racialisation intrinsic tohealthcare. Analytically, the excavation of racialised talk regards talk as reflective and constitutive of the dominant structures within which talk is situated. Drawing on qualitative interviews with 58 healthcare staff in Sweden, the thesis examines how healthcare staff’s racialised talk is used to devalue minority healthcare users and obfuscate racism. The findings of this thesis contradict previous characterisations of racism in today’s society as covert. Racialised talk against minority healthcare users is found to be overt and used to categorise minority users as ‘bad’ users and their health complaints as ‘unworthy’ by labeling symptoms as ‘ethnic’, ‘cultural’ or ‘functional’. The devaluingof minority healthcare users through talk further justifies differential and suboptimal care. Besides demonstrating that racialised talk in healthcare is overt, this thesis proposes that by emphasising healthcare neutrality and equality regulations, blaming minorities for racism, viewing racism as an individual aberration, locating racism outside both national and institutional contexts, healthcare staff manage (albeit inadvertently) to obfuscate racism. It is suggested that obfuscation of racism may serve to allow racism to be perpetuated, resulting in a culture of resignation, where resistance to racism isnegligible